Avelumab in patients with previously treated metastatic adrenocortical carcinoma: phase 1b results from the JAVELIN solid tumor trial

<h3>Background</h3> We assessed the efficacy and safety of avelumab, an anti-programmed death ligand 1 (PD-L1) antibody, in patients with previously treated metastatic adrenocortical carcinoma (mACC). <h3>Methods</h3> In this phase 1b expansion cohort, patients with mACC and...

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Main Authors: Christophe Le Tourneau, Christopher Hoimes, Corrine Zarwan, Deborah Jean Lee Wong, Sebastian Bauer, Rainer Claus, Martin Wermke, Hariharan Subramanian, Anja von Heydebreck, Vijay Kasturi, Vikram K. Chand, James L. Gulley
格式: Artigo
語言:英语
出版: 2018
在線閱讀:https://doi.org/10.1186/s40425-018-0424-9
https://jitc.bmj.com/content/jitc/6/1/111.full.pdf
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總結:<h3>Background</h3> We assessed the efficacy and safety of avelumab, an anti-programmed death ligand 1 (PD-L1) antibody, in patients with previously treated metastatic adrenocortical carcinoma (mACC). <h3>Methods</h3> In this phase 1b expansion cohort, patients with mACC and prior platinum-based therapy received avelumab at 10&nbsp;mg/kg intravenously every 2&nbsp;weeks. Continuation of mitotane was permitted; however, mitotane levels during the study were not recorded. Tumor response was assessed by Response Evaluation Criteria In Solid Tumors v1.1. <h3>Results</h3> Fifty patients received avelumab and were followed for a median of 16.5&nbsp;months. Prior treatment included ≥2 lines in 74.0%; mitotane was continued in 50.0%. The objective response rate (ORR) was 6.0% (95% CI, 1.3% to 16.5%; partial response in 3 patients). Twenty-one patients (42.0%) had stable disease as best response (disease control rate, 48.0%). Median progression-free survival was 2.6&nbsp;months (95% CI, 1.4 to 4.0), median overall survival (OS) was 10.6&nbsp;months (95% CI, 7.4 to 15.0), and the 1-year OS rate was 43.4% (95% CI, 27.9% to 57.9%). In evaluable patients with PD-L1+ (<i>n</i> = 12) or PD-L1− (<i>n</i> = 30) tumors (≥5% tumor cell cutoff), ORR was 16.7% vs 3.3% (<i>P</i> = .192). Treatment-related adverse events (TRAEs) occurred in 82.0%; the most common were nausea (20.0%), fatigue (18.0%), hypothyroidism (14.0%), and pyrexia (14.0%). Grade 3 TRAEs occurred in 16.0%; no grade 4 to 5 TRAEs occurred. Twelve patients (24.0%) had an immune-related TRAE of any grade, which were grade 3 in 2 patients (4.0%): adrenal insufficiency (<i>n</i> = 1), and pneumonitis (<i>n</i> = 1). <h3>Conclusions</h3> Avelumab showed clinical activity and a manageable safety profile in patients with platinum-treated mACC. <h3>Trial registration</h3> Clinicaltrials.gov NCT01772004; registered January 21, 2013.